First, getting the technology in place and the privacy and security standards implemented is complicated. The Department of Health and Human Services has been working on privacy regulations, as well as detailing what "meaningful use" should mean, for months now. The agency appears to be getting closer to final regulations, but somehow those to whom the regs will apply aren't any clearer on what their obligations will be.
What's more, after leadership changes, those who work in the Office of Interoperability and Standards are trying to wrap their collective brains around the integration and other challenges that a project this big entails. After all, even the e-records systems that individual health care providers and others subject to HIPAA and HITECH use aren't immune to problems.
A small survey recently conducted by Compuware illustrates the point. Of the 99 health care professionals (doctors, nurses, chief medical officers and chief medical information officers) who responded, a majority said they log in to their clinical information systems up to 20 times a day, and 60 percent said response times for a single log-in were greater than 10 seconds. Not surprisingly, nearly half found such response times unacceptable.
Such issues leave many end users with a sour taste in their mouths for technology. Convincing those users that a nationwide system is workable and worth their while will be a big challenge for the lawmakers and engineers who are working out the details - especially now, when doing the work to qualify for HITECH Act stimulus money seems impossible.